Provider Demographics
NPI:1265579833
Name:CLINE, KIMBERLY (FNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CLINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 1ST ST W
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-2106
Mailing Address - Country:US
Mailing Address - Phone:828-466-3000
Mailing Address - Fax:828-466-2338
Practice Address - Street 1:130 1ST ST W
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-2106
Practice Address - Country:US
Practice Address - Phone:828-732-7450
Practice Address - Fax:828-732-7451
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ18286Medicare UPIN
NC2592101AMedicare PIN